WESTERN PACIFIC RE-HAB (NPI# 1770922650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770922650 |
| Entity Type | Organization |
| Organization Name | WESTERN PACIFIC RE-HAB |
| Practice Address |
4544 San Fernando Rd Suite 201 Glendale CA 91204-1987 |
| Mailing Address |
4544 San Fernando Rd Suite 202 Glendale CA 91204-1987 |
| Practice Telephone | 8182408843 |
| Mailing Telephone | 8189563737 |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | MARK HICKMAN (CEO) |
| Authorized Official Telephone | 8189563737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
19-125 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA DRUG MEDI-CAL | 1949 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205275195 | Western Pacific Re-hab | Clinic/Center | 11902 Rosecrans Ave Ste A&d, Norwalk, CA 90650-4197 | 2013-06-24 |
| 1578902466 | Western Pacific Re-hab | Clinic/Center | 275 Victoria St Ste 1h, Costa Mesa, CA 92627 | 2013-06-24 |
| 1881033777 | Western Pacific Re-hab | Clinic/Center | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2013-06-24 |
| 1871932764 | Western Pacific Re-hab | Clinic/Center | 45335 Sierra Hwy, Lancaster, CA 93534-1611 | 2013-06-24 |
| 1437598323 | Western Pacific Re-hab | Clinic/Center | 7232 Canby Ave, Suites 4,5,6, Reseda, CA 91335-3006 | 2013-06-24 |
| 1922447812 | Western Pacific Re-hab | Clinic/Center | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2013-06-24 |
| Street Address |
4544 SAN FERNANDO RD SUITE 201 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91204-1987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235271180 | Western Pacific Med-corp | Clinic/Center | 4544 San Fernando Rd, Suite 201, Glendale, CA 91204-1987 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558997387 | Hope & Trust Trading LLC | Radiology | 318 W Colorado St #2, Glendale, CA 91204 | 2020-03-12 |
| 1972133387 | Yusuf Toliver | Counselor | 1027 S Central Ave, Suite 200, Glendale, CA 91204 | 2020-01-24 |
| 1538633136 | Pathology La Inc. | Clinical Medical Laboratory | 4634 San Fernando Rd., Same As Above, Glendale, CA 91204 | 2019-01-16 |
| 1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
| 1285163568 | Ez Trans, Inc. | Transportation Broker | 1626 S. Central Ave., Glendale, CA 91204 | 2017-06-08 |
| 1194254474 | Jenny Chung | Pharmacist | 3943 San Fernando Road, Glendale, CA 91204 | 2017-06-08 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1710302450 | New Age Foot and Ankle Podiatry PC | Podiatrist | 705 Ivy Street, Glendale, CA 91204 | 2014-03-04 |
| 1124454376 | Alber K. Karamanoukian Medical Clinic, Inc. | Clinic/Center | 810 S. Central Avenue, Suite 100, Glendale, CA 91204 | 2013-09-19 |
| 1548521156 | Glendale Plastic and Reconstructive Surgery Inc. | Plastic Surgery | 1500 S. Central Ave. #126, Glendale, CA 91204 | 2012-05-31 |
| Find all providers in zip 91204 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235271180 | Western Pacific Med-corp | Clinic/Center | 4544 San Fernando Rd, Suite 201, Glendale, CA 91204-1987 | 2007-02-13 |
| 1508356593 | Thunderbird Treatment Center Inc | Clinic/Center | 13820 N 51st Ave, Suite 400, Glendale, AZ 85306 | 2018-05-15 |
| 1720279441 | Western Pacific Med/corp | Clinic/Center | 4632 San Fernando Rd, Glendale, CA 91204-1822 | 2007-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1093323222 | City and County of San Francisco | Clinic/Center | 1001 Potrero Ave # Ward86, San Francisco, CA 94110-3518 | 2020-07-14 |
| 1548899644 | Bella Team Ltd. | Clinic/Center | 2618 San Miguel Dr Ste 1288, Newport Beach, CA 92660-5437 | 2020-04-02 |
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1518501527 | Harmonic Solutions LLC | Clinic/Center | 1776 Ygnacio Valley Rd Ste 206, Walnut Creek, CA 94598-3125 | 2019-11-01 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1306326699 | Kristen Andree Rickard | Clinic/Center | 1153 Paradise Trail Rd, Chula Vista, CA 91915-2502 | 2018-08-16 |
| 1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
| 1013448547 | Coachella Valley Treatment Center | Clinic/Center | 81709 Dr Carreon Blvd Ste B1, Indio, CA 92201-5510 | 2017-03-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.